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SNAPPS WRITTEN ASSIGNMENT TEMPLATE
What is the self-directed learning issue that was identified in your oral presentation?
|Management in a patient who has to frequently self-catheterize.
Research the self-directed learning issue and provide a summary of your findings which is fully supported by appropriate, scholarly, EBM references.
“Neurogenic bladder is defined as the dysfunction of the bladder, causing one to lack bladder control” (Engelke, & Schub, 2017). It can be caused due to neurologic disorders of the central nervous system (CNS) or peripheral nerves that controls micturition. Spinal cord injury (SCI), spina bifida, Parkinson’s disease, multiple sclerosis, diabetes, brain tumors, cerebrovascular accident, neural tube defects and other diseases cause dysfunctional bladder (Engelke, & Schub, 2017). Urologic problems cause an alternation of the lower urinary tract function, which have been a huge cause of morbidity and mortality in patients with SCI (Edokpolo, Stavris, & Foster, 2013).The bladders storage and emptying is affected causing persistent urinary retention. SCI plays an effect on the “urethral sphincter and the function of the detrusor muscle causing neurogenic voiding dysfunction” (Edokpolo, Stavris, & Foster, 2013).
Patients with dysfunctional bladders require intermittent catheterizations in which the bladder is emptied several times throughout each day, usually every four to six hours. There are many barriers that may occur with intermittent catheterizations, such as managing the occurrences, engaging in proper technique during each catheterization, inconvenience of catheterizing, inaccessible bathrooms, restrictions in traveling, and lack of optimal catheter supplies (Wilde, Fairbanks, Parshall, Feng, Miner, Thayer, McMahon, 2015). Complications include urine leakage and urinary tract infection (UTI). The most common complication in SCI patients is UTI. These patients are at risk that may develop “bladder over distention, outlet obstruction, detrusor sphincter dyssynergia, increased intravesical pressure, vesicourecteral reflux, and large post void residuals” (Edokpolo, Stavris, & Foster, 2013).
As providers, it is important to teach patients with intermittent catheterization that self-management skills are required. It is important to learn how to The important to learn how to follow a daily regime, monitor fluid intake and output, prevent leakage and stay hydrated. Patients should also be able to recognize the early symptoms of UTI (Wilde, et al, 2015). “Some signs and symptoms of UTI include fever, chills, lethargy, lower abdominal pain, back pain, flank pain, urgency, painful urination, hematuria, and change in mental status” (Engelke, & Schub, 2017).
Education should be given for basic intermittent catheter self management. Patients should drink more water, limiting coffee and sodas. Limit fluids in the evening. Keep an intake and output diary avoiding bladder distention as well as noticing how often one catheterizes. Note the color and consistency of urine and if there are any changes. Patients should be cautious of changes in activity levels, stress, and overall health (Wilde, et al, 2015). Patients should adhere to single use protocols using sterile technique. Eating foods containing lactobacillus, such as yogurt and taking vitamin C may prevent a UTI (Engelke, & Schub, 2017). Hand washing is most important for patients who self catheterize. Hand washing with soap and water prevents the spread of bacteria and prevent infection.
A study was conducted to evaluate a web-based approach as an intervention for people who frequently use intermittent catheterizations. Reports provide practitioner’s pertinent information about how patients self manage using graphs and tables to monitor intake and output. Specific topics on the website include optimal fluid intake, promote best intermittent catheterization interval, prevent leaking, urine output etc. The interactive diary allows peer led discussions, educational journals and goals (Wilde, et al, 2015). This is a beneficial intervention that patients could use who is using long-term intermittent catheterizations.
Edokpolo, L. U., Stavris, K. B., & Foster, H. E. (2013). Intermittent catheterization and recurrent urinary tract infection in spinal cord injury. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3584766/pdf/sci-18-187.pdf
Engelke, Z. R. M., & Schub, T. B. (2017). Patient education: Home care—Teaching intermittent self-catheterization in adults. CINAHL Nursing Guide.
Wilde, M. H., Fairbanks, E., Parshall, R., Feng, Z, Miner, S., Thayer, D., McMahon, J. M. (2015). A web-based self-management intervention for intermittent catheter users. Urologic Nursing, 35(3), 127-138. http://doi- org.chamberlainuniversity.idm.oclc.org/10.7257/1053-816X2015.35.3.127
SNAPPS is a learner-centered approach to case presentation in the clinical setting. This model allows the student to take an active role in their educational encounter by discussing the patient encounter beyond the facts, verbalizing their clinical reasoning, asking questions, and engaging in follow-up learning pertinent to the educational encounter. This exercise is designed to develop the student’s ability to organize patient information in a meaningful way and guide the student in their oral patient presentations in the clinical setting.
- Using a patient seen in their clinical setting, students will give an oral presentation (via Kaltura) using the 6-step learner-centered SNAPPS model to mimic a real-life presentation to the preceptor by:
- Briefly summarizing the relative history and findings;
- Narrowing the differential to three relevant possibilities using the pertinent positive and negative findings;
- Analyzing the differential by comparing and contrasting the possibilities;
- Probing the preceptor by asking questions about uncertainties, difficulties, or alternative approaches;
- Identifying a treatment plan for the patient; and
- Select a case-related issue for self-directed learning
- In addition to the oral presentation, the student will submit the written findings of their research for the case-related, self-directed learning topic that was identified in the presentation.
ONLY DO THE WRITING PORTION OF THE ASSIGNMENT AS THE SAMPLE PROVIDED
- The written portion of this assignment will be submitted on the “SNAPPS Template for Written Assignment” using appropriate evidence-based, scholarly references and using appropriate APA reference and in-text citations.
The written portion of this assignment should be prepared using the following guidelines:
- The student’s findings of the self-directed learning topic must be completed on the “SNAPPS WRITTEN ASSIGNMENT TEMPLATE”
- The report should be between 5-7 paragraphs in length, discussing something learned from the student’s research about the self-directed learning topic.
- Correct grammar, punctuation, and spelling should be observed.
- In-text citations and reference page should be written in APA format and scholarly evidence-based medicine (EBM) references must be used.
NR511 W5 SNAPPS Presentation Rubric
|NR511 W5 SNAPPS Presentation Rubric|
|This criterion is linked to a Learning OutcomeSummarize the H&P in a brief and concise manner. The summary includes the chief complaint (CC), history of present illness (HPI), and subjective and objective findings that are relevant to the case. The summary should not contain additional unnecessary data (4 critical elements required).||
|This criterion is linked to a Learning OutcomeNarrow the differential diagnosis. The student identifies 3-4 reasonable diagnoses as part of the differential||
|This criterion is linked to a Learning OutcomeAnalyze the differential using key positive and negative findings to argue for or against a diagnosis, and rank diagnoses in order from most to least likely in the oral presentation (2 critical elements required)||
|This criterion is linked to a Learning OutcomeProbe the preceptor/instructor with self-identified knowledge gaps, points of confusion or dilemmas in the oral presentation. Student verbalizes three (3) questions that were addressed to preceptor regarding knowledge gaps, points of confusion or dilemmas AND All questions are directly related to the case study (2 critical elements required).||
|This criterion is linked to a Learning OutcomeAt a novice level, the student proposes an appropriate management Plan in the oral presentation. The plan addresses: 1) how the student confirmed or established the diagnosis, 2) medications chosen (OTC or RX) with dosages noted, 3) patient education and 4) follow-up for the problem AND 5) Consideration to cost, availability, or patient preferences are mentioned in regards to treatment considerations. (5 critical elements required).||
|This criterion is linked to a Learning OutcomeIdentify a self-directed learning topic. Student verbalizes at least one issue for self-directed learning in the oral presentation AND Provides written research on the self-directed learning topic AND Research is fully supported by at least three (3) appropriate, EBM, scholarly references (3 critical elements required)||
|This criterion is linked to a Learning OutcomeThe student’s oral presentation is a minimum of five (5) but no more than seven (7) minutes in length AND The written research of the self-directed learning topic is five (5) to seven (7) paragraphs in length AND The research is submitted on the SNAPPS written template AND All in-text citations and references are written in correct APA format (4 critical elements required).||
|Total Points: 100.0|